Living with Bariatric Surgery: Managing your mind and your weight

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Coulman KD, et al. (2020). Patients’ experiences of life after bariatric surgery and follow-up care: A qualitative study. With this in mind, Groven plans to conduct further research that will look at the effects of bariatric surgery 3-10 years after patients have undergone the procedure. Some women were worried about eating too much or too little, or eating the wrong food at the wrong time. Because of these concerns, some women experienced tiredness, nausea, dizziness and even intense shaking. Surgery usually takes several hours. After surgery, you awaken in a recovery room, where medical staff watches you for any complications. Depending on your procedure, you may need to stay a few days in the hospital. Types of bariatric surgery You may also need to start with a liquid diet before gradually eating solid foods again. After a week or so, the doctor will likely clear you to begin transitioning off of your liquid diet.

Each type of bariatric surgery has pros and cons. Be sure to talk to your doctor about them. Here's a look at common types of bariatric surgery:During the second step, the surgeon closes off the middle section of the intestine and attaches the last part directly to the first part of the small intestine, called the duodenum. This is the duodenal switch. The separated section of the intestine isn't removed from the body. Instead, it's reattached to the end of the intestine, allowing bile and pancreatic digestive juices to flow into this part of the intestine. This is the biliopancreatic diversion. Several participants did not live locally to the hospital where the specialist team were located. This presented a barrier to accessing follow-up care, which some felt could contribute to feelings of isolation: ‘From this side of the county it’s (hospital) extremely difficult to get to…I can understand an awful lot of people thinking ’if I ring [hospital] they’re going to say come over and see me and that is so difficult to get to…I won’t bother’ (P15). Equally participants described how local primary care services were unable to support them compounding their feelings of isolation: ‘Unless they’ve (GP surgery) read my notes they don't even know I’ve got one (a gastric band)’ (P04), and ‘They (GP surgery) were very much like ‘it’s a secondary care issue, it’s not primary care’ (P07). The bypass routes food through only about 10 feet of the small intestine, instead of the usual 25. This means there is less time and distance for the body to absorb fat and calories.

Consider sending the patient the BOMSS pre-consultation questionnaire for patients prior to their review appointment to identify potential problems. If using this questionnaire ask the patient to bring the completed form with them to the appointment. Life expectancy in patients with obesity has also been studied in the context of BMI “trajectories.” A study using data from the U.S. Health and Retirement Study, which included adults aged 51 to 77 years, defined 6 categories of BMI trajectories. These included normal weight downward, normal weight upward, overweight stable, overweight obesity, class I obese upward, and class II/III obese upward. Confirming a finding seen in prior studies, individuals in the overweight stable group had the highest survival rate, while individuals in the class II/III upward trajectory had the lowest survival rate. This finding persisted after controlling for socioeconomic factors and multiple chronic illness states. Using an attributable risk analysis, the authors found that about 7.2% of deaths after age 51 were due to obese upward trajectories [10].Keep a coded register of all patients who have had a bariatric surgery procedure, using a major active problem code. Feldman M, et al., eds. Surgical and endoscopic treatment of obesity. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 11th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed June 24, 2023. Dr Ratcliffe explained that many patients do not ‘update’ their body image after surgery, so they look in the mirror and see themselves as the same size that they were before surgery. It can take the brain some time to catch up and she encourages patients to gather accurate information such as taking photos, paying attention to their new clothes size and noticing things they are physically able to do that were previously not possible.

Bleeding or perforation of the stomach or intestines: A perforation is when a hole develops through the wall of the gut. These are life-threatening emergencies that require immediate intervention. Such complications are more likely to occur after procedures that involve cutting away sections of the stomach. Bariatric surgery registry. 2019/2020 Annual Report. Melbourne: Monash University; 2021. [cited 2022 Sep 1]

Bariatric surgery

Consider using a post-bariatric surgery computer template to record information at annual review appointments. This is particularly evident in relationships where people are overweight and as one starts to lose weight after surgery, this can cause tension as one partner tends to feel left behind as their partner moves on and more things become possible,” she added. “If there were problems in the relationship before this can become more of an issue post-operatively. It does not tend to impact people who are in happy and functional relationships before surgery. Meet with your surgeon: This will happen a few weeks before the surgery and is a good time for you to ask questions. Monitor patients closely for signs of withdrawal or reduced efficacy. Doses may need to be increased or may require a change in formulation (e.g. to immediate release or liquid), particularly in the first six months following bypass surgery. Consult with a therapist or psychologist: They will assess whether you’re ready for the lifestyle changes that come along with bariatric surgery.

psychosocial distress, such as low self-esteem, teasing and bullying (see also NICE's guideline on managing overweight and obesity in children and young people) Increase your protein intake: to make sure your body is still getting the recommended amount of protein each day The message from the media and medical science is that they are likely to get cancer or diabetes unless they lose weight and the surrounding world regards their obesity as self-inflicted. Some have children and are afraid to die and leave them alone.” Advantages to this procedure include significant weight loss and no rerouting of the intestines. Sleeve gastrectomy also requires a shorter hospital stay than do most other procedures. Parikh M, Johnson JM, Ballem N; American Society for Metabolic and Bariatric Surgery Clinical Issues Committee. ASMBS position statement on alcohol use before and after bariatric surgery. Surg Obes Relat Dis 2016;12:225-30.After weight-loss surgery, you generally won't be allowed to eat for 1 to 2 days so that your stomach and digestive system can heal. Then, you'll follow a specific diet for a few weeks. The diet begins with liquids only, then to pureed and very soft foods, and eventually, to regular foods. You may have many restrictions or limits on how much and what you can eat and drink.